Dr Rebecca Brown

Research Fellow

Becky is a postdoctoral research fellow on the ‘Individual Responsibility and Healthcare’ project (PI Julian Savulescu, funded by the Wellcome Trust). Her work considers ethical issues surrounding efforts to promote healthy lifestyles and the extent to which people can – and should – be held responsible for their health-affecting behaviour. As an undergraduate, Becky studied Veterinary Medicine, before switching to History and Philosophy of Science. She undertook a PhD as part of the Wellcome-funded Centre for the Study of Incentives in Health, investigating the use of financial incentives to encourage healthy behaviours. Subsequently, Becky worked as a research fellow in Applied Ethics at the University of Aberdeen, focusing on ethical issues arising in the context of Health Services Research. Becky’s interests cover a range of topics within Practical Ethics, focusing particularly on interdisciplinary work which incorporates empirical research from the Behavioural Sciences into Moral and Political Philosophical theory in order to address practical questions in social policy and public health.

Journal Articles

Responsibility, prudence and health promotion.

Brown, RCH, Maslen, H, Savulescu, J

2018

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Journal article

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Journal of public health (Oxford, England)

This article considers the role of responsibility in public health promotion. Efforts to tackle non-communicable diseases which focus on changing individual behaviour and reducing risk factor exposure sometimes invoke individual responsibility for adopting healthy lifestyles. We provide a critical discussion of this tendency. First, we outline some key distinctions in the philosophical literature on responsibility, and indicate how responsibility is incorporated into health promotion policies in the UK. We argue that the use of some forms of responsibility in health promotion is inappropriate. We present an alternative approach to understanding how individuals can 'take responsibility' for their health, based on the concept of prudence (i.e. acting in one's interests). In this discussion, we do not prescribe or proscribe specific health promotion policies. Rather, we encourage public health professionals to consider how underlying assumptions (in this case, relating to responsibility) can shape health promotion policy, and how alternative framings (such as a shift from encouraging individual responsibility to facilitating prudence) may justify different kinds of action, for instance, shaping environments to make healthy behaviours easier, rather than using education as a tool to encourage responsible behaviour.

Social values and the corruption argument against financial incentives for healthy behaviour.

Brown, RCH

2017

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Journal article

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Journal of medical ethics

Financial incentives may provide a way of reducing the burden of chronic diseases by motivating people to adopt healthy behaviours. While it is still uncertain how effective such incentives could be for promoting health, some argue that, even if effective, there are ethical objections that preclude their use. One such argument is made by Michael Sandel, who suggests that monetary transactions can have a corrupting effect on the norms and values that ordinarily regulate exchange and behaviour in previously non-monetised contexts. In this paper, I outline Sandel's corruption argument and consider its validity in the context of health incentives. I distinguish between two forms of corruption that are implied by Sandel's argument: efficiency corruption and value corruption While Sandel's thought-provoking discussion provides a valuable contribution to debates about health policies generally and health incentives specifically, I suggest the force of his criticism of health incentives is limited: further empirical evidence and theoretical reasoning are required to support the suggestion that health incentives are an inappropriate tool for promoting health. While I do not find Sandel's corruption argument compelling, this only constitutes a partial defence of health incentives, since other criticisms relating to their use may prove more successful.